PacificSource Health Plans

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PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

Secure, build, and sustain positive working relations with key constituents including groups, brokers, external vendors, and internal departments. Foster a partnership and enhance dialogue with groups, while acting as a subject matter expert. Assist PacificSource groups and brokers in building strategically designed benefit programs to support cost containment, quality care, wellness programs and compliance with legal and regulatory guidelines. Participate in the renewal process. Participate in the evaluation of, and responses to, requests for proposals for existing/renewing groups. Actively seek opportunities to sell additional PacificSource services to current groups. Ensure existing groups are satisfied with and recognize the value offered by PacificSource. Book of business is predominately large group (mix of fully insured and self-funded).

Essential Responsibilities:

• Coordinate with Sales Executive to make sure there is a clear understanding of the products and services sold to any new PacificSource groups. For renewing groups within your block of business communicate any services sold that would apply at renewal and coordinate with Sales Executive for any renewal not included in your block of business. Partially responsible along with Sales Executive to negotiate renewal. Complete any documentation necessary to implement or renew Groups.
• Consult with Groups to ensure they are informed regarding PacificSource products, administrative procedures, population health strategies, and legislative and compliance requirements. Follow service model guidelines for Group outreach appropriate to the size of the group, small or large group.
• Serve as a resource for benefits, compliance, and plan information. Communicate with Groups, providers, PacificSource departments, and Sales to assure clear communication between all constituents.
• Attend internal and external meetings as required. Share best practices with team.
• Work to identify potential issues and seek resolution(s).
• Liaison to outside vendors which provide services/products to our Groups, including but not limited to, Pharmacy Benefit Managers, Wellness Programs, EAP Providers, Benefit Administration Systems, 834 Vendors, and other ancillary programs or services.
• Work with Groups and consultants to develop the strategic direction of the Groups’ employee benefit plans. Create and help execute a roadmap to accomplish Groups’ goals.
• Present and review Group reporting package, identify trends, tools, and proposed course of action to help meet Group goals. Where applicable offer additional PacificSource solutions that resolve a Group want/need.
• Lead internal and external implementation and renewal meetings.
• Review plan documents before delivery to ensure accuracy. Deliver and review the plan administrator manual, contract documents, amendments, benefit books, billing procedures, and other group information. Negotiate with brokers and group in order to renew Groups’ assigned to you. Include underwriting and sales executive as needed.
• Follow up with consultant/brokers on renewal status, renewals rates, develop alternate or optional benefit quotes, as appropriate on groups in your assigned block of business, and coordinate with Sales Executive on all other groups assigned to you.
• Determine reasons for Group terminations and record information for team/executive review
• Participate in Group enrollment/employee benefit meetings, wellness/health fairs.
• Prepare materials and presentations for meetings, Conduct/participate in new group enrollment and orientation meetings.
• Receive, analyze, and respond to Group issues and assure timely, appropriate follow-up.
• Serve as Group contact and problem solver for a wide range of contract issues relating to medical, dental, pharmacy, and optional benefits; supply requests; problem resolution; and claims issues.
• Identify cross selling opportunities to existing PacificSource Groups.
• Represent PacificSource, both internally and externally, as required at events, including but not limited to: Health Underwriters and Human Resource professional association meetings and conferences, Chamber of Commerce, and any other community activities or volunteer opportunities.

Supporting Responsibilities:

• As requested, participate in and lead company benefit training programs.
• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: Three (3) years in sales, account management, or employee benefits experience required.

Education, Certificates, Licenses: High school diploma or equivalent required. Bachelor’s degree in Business Administration or related field preferred. Current Life and Health Insurance License or to be obtained within 6 months in the role.

Knowledge: A thorough understanding of insurance products, contracts, administrative procedures, and the health insurance industry’s legal and mandatory guidelines preferred. Knowledge of Underwriting model. Ability to remain current on PacificSource administrative procedures and products, healthcare, and the health insurance industry. Excellent communication skills, both verbal and written. Ability to communicate effectively with all types of individuals. Excellent public relations skills and public speaking ability. Ability to effectively explain plans and administration to groups of varying educational backgrounds and familiarity with benefits. Ability to effectively communicate with various internal departments. Ability to provide prompt, professional, and courteous service to customers, brokers, and PacificSource employees. Ability to work in a fast-paced environment, managing shifting priorities and multiple tasks simultaneously. Superior work leadership skills, including taking action without specific direction. Requires a high level of integrity and trust, given frequent exposure to confidential material. Demonstrated ability to remain resilient, flexible, and focused in a changing environment. Work autonomously and independently. Desire to learn new things, anticipate problems, and develop contingency plans to manage them. Travel, with some overnight visits required. Proficient in Microsoft Word, Excel, PowerPoint, and Outlook.

Competencies:

Assignment Management

Becoming a Business Advisor

Building Trusting Relationships

Devising Sales Approaches and Solutions

Marshaling Resources

Sales Disposition

Sustaining Customer Satisfaction

Environment:

Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 40-50% of the time. Generally, travel by automobile and some overnight stays.

Skills:

Accountability, Business & financial acumen, Collaboration, Communication, Developing Networks, Flexibility, Listening (active), Strategic Thinking

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

• We are committed to doing the right thing.
• We are one team working toward a common goal.
• We are each responsible for customer service.
• We practice open communication at all levels of the company to foster individual, team and company growth.
• We actively participate in efforts to improve our many communities-internally and externally.
• We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
• We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.